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versión On-line ISSN 2078-5135versión impresa ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.100 no.3 Cape Town mar. 2010

CORRESPONDENCE

Millions of 'snips' will harm millions of men

To the Editor: I was alarmed by the headline: 'Millions of "snips" will bolster our health system' in Chris Bateman's summary of presentations at an October 2009 AIDS/TB meeting of 'global researchers' in Cape Town.1 As an American man with an interest in bodily rights, I find it offensive to hear the traumatic and sexually crippling amputation of the most erogenous portion of a boy's or man's penis described as comparable with snipping off the protruding end of a fingernail. Current gold-standard medical ethics and human rights preclude such a notion. If Bateman has good reason to assume that this word choice might harmonise with the views of subscribers to the SAMJ (many of whom are doctors, public health officials, and scientists), I am doubly alarmed that such attitudes may be widespread among the very people who have the power to activate the multinational male circumcision (MC) rollout described in this report.

It is unfortunate that Kelly Curran's grinning face appears directly beneath the headline, almost as if the 'snips' word choice were hers - an impression that is reinforced by the fact that her apparent delight in the many 'health benefits' of circumcising millions of Africans is featured throughout the article, supported by the 'incredible excitement' about the MC rollout expressed by Professor Francois Venter. Lost in all this excitement is the fact that circumcision does not fully prevent HIV/AIDS. In fact, circumcision may even help to spread AIDS from men to women if the use of condoms (a much more humane and effective solution) comes to be neglected because of the dulling of sexual sensation that occurs when men (or baby boys) are circumcised.

It is even more unfortunate, I believe, that no one appears to have been invited to defend the foreskin at this meeting. If such a person had been allowed to speak, it might have been clearer to attendees that the MC rollout that has been proposed, whether or not it diminishes cases of HIV/AIDS in Africa, will damage the joys of manhood for male Africans on a scale comparable with the anti-foreskin campaign that unfolded in my homeland over the last century. My guess is that most, if not all, of the men who are urging MC in Africa were circumcised as infants. As Ronald Goldman, author of Circumcision: The Hidden Trauma, has said, such men 'don't know what they're missing'. In fact, in my view, there is an inherent conflict of interest in allowing anyone who has grown up circumcised to make decisions about whether or not it is in the best interests of anyone else to lose his foreskin. Similarly, circumcising nations such as Israel and the USA have had a suspiciously disproportionate influence in developing studies and influencing policies aimed at encouraging universal circumcision in Africa as the solution to the terrible scourge of HIV/AIDS.